Like many European countries, the home birth rate in Ireland is low. Whether the absence of support nationally, within the health service, for a community midwifery service, leads to the absence of choice and subsequent lack of demand for home birth, or the low numbers do reflect an actual lack of demand from women is not known.
To date, as there is no national community midwifery service provided by the Health Service Executive (HSE), Self Employed Community Midwives (formerly Independent Midwives) provide this service for women who choose home as their place of birth. Service provision is based on the availability of SECMs and their geographical location.
This has been the case since the 1970’s when home birth all but disappeared.
Midwives are the experts in normal pregnancy, birth and newborn care. Self Employed Community Midwives work in a distinct way. They provide continuity of care through the childbearing experience to women who engage their services. They are self employed in this role and provide a 24 hour/365 days a year midwifery service. In an ideal situation, midwifery partnerships are recommended, but due to the small number of midwives and logistics this is not always possible. SECMs endeavour to have a second midwife in attendance, as mandated within their MOU/agreement, for all planned home births.
All midwives within the CMA have a contract with the HSE via a Memorandum of Understanding and Agreement which outlines the service they provide, eligibility criteria, ongoing assessment and the payment schedule. All our midwives complete the required mandatory education and training requirements, meet with their HSE managers biannually and partake in a professional peer review and reflection process which recognises the philosophy, practice and community based environment within which we work. Additionally, our annual statistics are forwarded to the National Perinatal Epidemiology Centre (NPEC) and we offer the opportunity for client feedback.